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What do my lab test results indicate?

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Posted on Thu, 28 Jul 2016
Question: year 2014
I am of 31 years
USG i have been diagnosed of prostate of volume 16cc. prostate gland weight 25 gms .
Prevoid UB volume 503cc
Postvoid UB Volume 358 cc
. no RUG TEST NORMAL, NO SPINAL INJURY.ALL BLOOD TEST NORMAL. URINE TEST SHOW PUS CELL 1-2/HPF. CA OXLATE PRESENT.
I have been advised to take ALFOO for 30 days.
I AM TAKING ALFOO FOR 40 DAYS. BUT NO BENEFIT. DOCTOR START ONE MORE MEDICINE DAILY URIMAX 0.4MG MORNING TIME AND ALFOO AT NIGHT.but after taking medicine no good result are showing. and doctor advised me to stop taking all medicine and suggested me to urodynamic emg test.last 2 years before,
till today ( JULY 2016 ) i no urodyanmic test performed. on 26.july 2016 another doctor suggested me to urine complete and urine culture test. and the report urine test
urine c/e pH of urine - alkaline
microscopy . pus cell -OCCASIONAL /hpf.
urine culture report show- gram negative bacilli bacteria ( Proteus Mirabilis present ).
culture senstivity report
amikacin- sentive (16)
amoxyclave- senstive (8)
cefoperazone/sulbactum- senstive less than 8
piper/tazobactam- senstive less than 4
nitrofurantoin -senstive ++

please suggest me which antibiotic good for this type bacteria. complete course? dose?

i like to mention i have been working as lab technician since last 13 years. in hospital.




IN YEAR 2014. AFTER RUG TEST DOCTOR ADVISED ME TAKE ANTIBIOTC ZANOCIN 200MG FOR 5 DAYS. AFTER TAKING THIS MEDICINE MY URINE RETENTION NORMAL AND URINE FLOW VERY GOOD. THATS WHY URODYNAMIC NOT PERFORMED. BEACAUSE I THINK MY PROBLEM IS BECAUSE OF BLADDER INFECTION ( CHRONIC)
AND MY CULTURE REPORT 26.7.16 SHOWS OFLAXIN -S+.
doctor
Answered by Dr. Dr. P. T. Patil (36 minutes later)
Brief Answer:
You probably have Neurogenic Bladder .

Detailed Answer:
Hello
Thanks for your query ,based on the facts that you have posted it appears that you have Neurogenic Bladder with secondary UTI.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Have you ever consulted any Urologist?
2) Have you done Urodynamic study of bladder ?
3) Was endoscopic examination of bladder (Cystoscopy done by any Urologist?)
4) Is it possible for you to upload report of Ultrasound Scanning ?
5) Do you have to strain to pass urine ?
6) How is your urine stream Weak .Moderate or Normal?

In view of the significant post void residue of 358 cc and your young age which is not a age to get enlarged prostate I think you have Neurogenic Bladder and needs to get investigated to establish diagnosis.

Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis.
1) Urine routine and culture.
2) Ultrasound scanning of abdomen and pelvis
3) Urodynaemic study of bladder and Pressure studies (Cystometry).
4) Endoscopic Examination of bladder (Cystoscopy)

Further treatment will depend upon result of these tests and final diagnosis.

In the mean while you can start taking Amikacin 500 mg twice daily along with Nitrofurantoin twice daily as per sensitivity reported in your recent urine culture report .

This will take care of infection but primary importance is to rule out Neurogenic bladder .

Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you .
Thanks and Regards.
Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (6 hours later)
1) Have you ever consulted any Urologist? Ans. YES
2) Have you done Urodynamic study of bladder ? ANS. NO
3) Was endoscopic examination of bladder (Cystoscopy done by any Urologist?) ANS. NO
4) Is it possible for you to upload report of Ultrasound Scanning ? ANS .YES
5) Do you have to strain to pass urine ? ANS .YES
6) How is your urine stream Weak .Moderate or Normal? WEAK.


BUT SIR, LAST MONTH I TAKE ZANOCIN 200MG FOR 5 DAYS, FOR FEW DAYS EVERYTHINGS NORMAL FOR SHORT PERIOD MEANS GOOD URINE STREAM,NO STRAIN PASSING URINE, COMPLETE EMPTY BLADDER. URO FLOW VERY GOOD.
AND IF I TAKING CRANBERRY JUICE REGULARY GOOD RESULTS FIND. EMPTY BLADDER

MY QUESTION . IF U SAYING THIS IS NEROGENIC DISODER THEN HOW CAN I GET RELIEF BY TAKING ANTIBIOTIC AND CRANBERRY JUICE. I AM SO CONFUSED.
ABOUT THIS .
doctor
Answered by Dr. Dr. P. T. Patil (2 hours later)
Brief Answer:
You need to get Urodynaemic study and Cystoscopic examination done .

Detailed Answer:
Hello
Thanks for follow up .

The symptomatic improvement that you got after taking Zanocin and canbery juice
is subjective and not longer lasting and of no clinical significance as it is not documented either by uroflowmetry or USG..

Neurogenic bladder can be rule out or confirmed only by doing Urodynaemic study and Cystoscopic examination .

The ultrasound scanning that has been done is incomplete in the sense that he has not mentioned about the thickness of bladder wall.

Please get these tests done .It is in your interest to establish diagnosis before planning next course of action .

Thanks and Regards.

Dr.Patil.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (20 minutes later)
sir please advice me medicine for current UTI INFECTION. HOW MANY DAYS TAKE AMIKACIN AND NITROFURATION TAB. ( DAYS AND DOSE )
MY BODY WEIGHT IS 55KG AND HIGHT 5'7".

AND AFTER THAT WHEN I WILL GO FOR URODYAMIC TEST ?


UPLOAD COPY OF ANOTHER USG WHICH SHOW BLADDER THICKNESS .
doctor
Answered by Dr. Dr. P. T. Patil (6 hours later)
Brief Answer:
Medicines to be taken are suggested as detailed below.

Detailed Answer:
Hello
Thanks for follow up .

you can take Amikacin 500 mg twice daily along with Nitrofurantoin twice daily for a week as per sensitivity reported in your recent urine culture report .

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. P. T. Patil (1 hour later)
uroflow recent report attached.

and culure report of another lab.which shows nitrofurantion resistent.
doctor
Answered by Dr. Dr. P. T. Patil (14 minutes later)
Brief Answer:
I have gone through Uroflowmetry report

Detailed Answer:
Hello
Thanks for follow up .I have gone through your uroflowmetry report which reveals average urine flow to be 3.6 ml which is very low as compared to be normal value of 15 ml per second .

One thing I have to mention that why a young man of 32 years old should have chronic UTI and that needs to be investigated thoroughly .

I still suggest you to get Urodynaemic study and Cystoscopic examination done at earliest .

Choice is yours .

Thanks ans Regards.

Dr.Patil.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Dr. P. T. Patil

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What do my lab test results indicate?

Brief Answer: You probably have Neurogenic Bladder . Detailed Answer: Hello Thanks for your query ,based on the facts that you have posted it appears that you have Neurogenic Bladder with secondary UTI. I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Have you ever consulted any Urologist? 2) Have you done Urodynamic study of bladder ? 3) Was endoscopic examination of bladder (Cystoscopy done by any Urologist?) 4) Is it possible for you to upload report of Ultrasound Scanning ? 5) Do you have to strain to pass urine ? 6) How is your urine stream Weak .Moderate or Normal? In view of the significant post void residue of 358 cc and your young age which is not a age to get enlarged prostate I think you have Neurogenic Bladder and needs to get investigated to establish diagnosis. Please consult qualified Urologist for clinical and digital rectal examination and get following basic tests done to confirm the diagnosis. 1) Urine routine and culture. 2) Ultrasound scanning of abdomen and pelvis 3) Urodynaemic study of bladder and Pressure studies (Cystometry). 4) Endoscopic Examination of bladder (Cystoscopy) Further treatment will depend upon result of these tests and final diagnosis. In the mean while you can start taking Amikacin 500 mg twice daily along with Nitrofurantoin twice daily as per sensitivity reported in your recent urine culture report . This will take care of infection but primary importance is to rule out Neurogenic bladder . Hope I have answered your query ,please feel free to ask if you have more questions , I shall be happy to help you . Thanks and Regards. Dr.Patil.